Nadine J. Cohen
A warning. This episode contains references to death and other themes related to dying, including suicide, euthanasia and voluntary assisted dying. Please take care.
Dr. Philip Nitschke
We've got members all around the world of our organisation, a lot of them in Australia, and they say, look, thanks for the laws that have come in, but we want control. I want something in the cupboard that I can go to and take and die, and I control it. Now. That's a very, very, very common request
by our 80 year old members.
Nadine J. Cohen
Welcome to "Grave Matters", a, lively look at death.
Anthony Levin
All of us at "Grave Matters" would like to acknowledge the traditional owners of the land we are recording from. We pay our respects to the Cammaraygal people and their elders, past and present. We also acknowledge the traditional owners from all Aboriginal and Torres Strait Islander lands and other
First Nations territories from which you are listening.
Nadine J. Cohen
Anthony Levin. Hola.
Anthony Levin
Nadine J. Cohen. Hello.
Nadine J. Cohen
So, what are we talking about this week?
Anthony Levin
Well, Nadine, you've heard of 3D printing, right?
Nadine J. Cohen
I have indeed.
Anthony Levin
And if you had to guess, what would you say is the strangest thing that's ever been 3D printed?
Nadine J. Cohen
I mean, guns, but also Donald Trump Jr.'s teeth.
Anthony Levin
Ooh, burn. Yes, I think the, printer setting might have been set to porcelain toilet on that one. Well, technology has now made it possible to 3D print a machine which could help someone to die with dignity when and where they choose. As of 2025, there are around 300 million people globally who have
access to assisted dying laws. Most of them are for people with terminal illness or unbearable conditions. But in places like Switzerland, the laws are more permissive and assistive technologies are increasingly taking doctors out of the equation. In today's episode, we ask some difficult questions.
Should a person have a right to die? And if so, under what circumstances? Is it ever rational to want to end one's life? If technologies are making it easier and safer to die with dignity, who are we to get in the way? Nadine, is this just human progress or should we rail against all forms of
suicide, assisted or not? And I ask that question knowing that you yourself are no stranger to this subject.
Nadine J. Cohen
Yeah, look, obviously my - as you know, my relationship to this subject is quite personal. I am a survivor. I, even still, I don't feel qualified to answer these questions. Like, I definitely 100% believe that voluntary assisted dying should be legal and should be available to people with terminal
illness, unbearable conditions, certain mental health conditions. But then a part of me is also like, if someone wants to die, they want to die. Like, I just - I don't feel that this is one where my personal experience lends to expertise. I don't think anyone knows these answers and I don't think
there is a right or wrong here.
Anthony Levin
So you feel a little bit conflicted about it?
Nadine J. Cohen
Definitely. Yeah, I definitely feel conflicted about it. Part of me just wants to say yes, if, like, anyone wants to die, that's fine. And I do feel that in terms of things like mental illness, emotional pain should be given the weight of physical pain as well, because I think they are as
destructive and as difficult to live with. But I don't like saying just anyone can do it. It is still a step too far for me.
Anthony Levin
You feel there still need to be some guardrails around this?
Nadine J. Cohen
I think so. And obviously the hardest one here. I mean, mental health issues are a hard topic here, but then also obviously, neurological issues, ageing issues, dementia. You know, I do think that we need to, set things like advance care directives in place that say, I want to die if I have one of
these illnesses. But yeah, I don't think there should be just hard and fast rules. And it's just like, yep, anyone can die. Like, it's a difficult topic for a reason. It's maybe the most difficult topic that we face.
Anthony Levin
Yeah, that's well said. And as we'll see, even the subject of advance care directives is not without its complications. So today we're speaking with renowned end of life advocate, Dr. Philip Nitschke. In 1996, Philip became the first doctor in the world to administer a legal lethal voluntary
injection to four patients in Darwin under the Northern Territory's voluntary assisted dying law. He is the founder of Exit International, a not for profit dedicated to ensuring that people have the right to determine the time and manner of their death. And he is an author and inventor of several
assisted dying machines. And when he's not travelling the world advocating for humane end of life options for people of sound mind, he lives on a houseboat in the Netherlands with his wife, Fiona, and their two dogs. Dr. Philip Nitschke, welcome to "Grave Matters".
Dr. Philip Nitschke
Well, thank you.
Anthony Levin
We're going to get right into it. Philip, you're probably the most renowned figure in the euthanasia, or voluntary assisted dying movement, but you have, in fact, worn many hats in your lifetime. You have a PhD in laser physics. I imagine many people don't know this about you. You've worked as a
tram conductor, a taxi driver.
Anthony Levin
And you've had an early career as a Parks and Wildlife ranger until you broke your leg badly. And then you decided to study medicine and you graduated from Sydney University Medical School in 1989.
Anthony Levin
As a mature age student, what was it that drew you towards end of life advocacy?
Dr. Philip Nitschke
That was an accident. I mean you're right about that summary. I did my medical training as a so called mature age or geriatric student and then I went and did my interning. You had to do your interning somewhere. I went back to what had been my home for so many years, which is the Northern
Territory. The only place there, even though I'd been living in Central Australia, was to go to Darwin where the hospitals were big enough for taking interns. And I was working there as a sort of resident medical officer in the hospital when I just heard about it on the radio, which was 1994, when
it was first mentioned. The leader of the government in the territory then was Marshall Perron. It was a conservative government and he just announced one day he thought it was a good idea to allow people who were terminally ill to get help from a doctor to have a lethal injection. I mean I hadn't
been thinking about end of life issues at all. And I must say that I hadn't had much to do with people who were dying. I mean I met a few people by that stage in hospital who were in that situation, but it certainly was not a, not a particular field, et cetera. But I heard about it on the radio,
thought good idea, rolled over and went back to sleep, and was totally taken aback by the huge pushback over the next few days. In fact the next, for almost forever, but certainly in that first week or two, predominantly coming from the medical, profession. My new profession.
Nadine J. Cohen
Philip says the government's announcement received widespread support in the Northern Territory community. That dovetails with a public opinion poll from 1995, where 75% of people surveyed said they supported a law to protect doctors who help terminally ill patients to die. But over the next year of
social and political debate, that support was gradually eroded by organisations like the Australian Medical Association and the Northern Territory Council of Churches. The Central Land Council, which advocates for indigenous land rights, also strongly opposed the law, saying it was culturally
Dr. Philip Nitschke
The people of the territory thought it was a very good idea, but they were saying, look, we're the doctors, we know what's best for you. You think you know about death and dying, but we're the experts. And I found that very hard to take. I thought, I can imagine as many people in the territory that
don't like being told what they should be thinking about death and dying. We've all got clear ideas on it. It's not up to some expert and certainly some expert group to effectively say they know what's best for us. So that reaction from my profession disappointed me. In fact, they were saying there
isn't a doctor in the territory who would participate in such legislation. It would be a world first. And I thought, well, that's too much. So I've managed to find a few other doctors, not many. And we took out a full page ad in the Northern Territory News and saying, look, they're saying there
isn't a doctor, but here's a group of, I think it was half a dozen of us, who would participate in such a law. And that was actually politically important because when it went to the vote, it was a small assembly. There still is only 25 politicians and it split 13-12, and it passed by one vote. So
Perron got it through. He was pretty skilled politician, but he only just got it through. And he was quite openly acknowledging the fact that we had come in as a group, really countering the very effective political opposition from the medical profession. So it came in and went into effect on
Anthony Levin
It may seem improbable, but on that day in 1996, the Northern Territory became the first jurisdiction in the world to legalise voluntary assisted dying. And in September of that year, a Darwin man named Bob Dent became the first person in the world to die after receiving a legal, lethal, voluntary
injection. For Philip, it was a watershed moment.
Dr. Philip Nitschke
When he pressed the button on the machine that I'd built and I sat there in the room. Well, I felt immediately, relieved that the machine had worked. But I also knew the things were never going to be the same.
Nadine J. Cohen
In such uncharted territory, it's understandable that Philip felt relieved when his so called "Deliverance Machine" worked. But we also wanted to know how he responded to the intimacy of helping a person decide to end their life.
Dr. Philip Nitschke
Heavens, I wasn't very enthusiastic about it. It made me feel like an executioner. And I didn't like the thought. I mean, I knew I could sit there somehow or other, get a needle into a vein, inject the drugs and have him die on the end of the needle. But I thought, I don't see why I should become an
executioner. Why can't I build a device that makes it very clear that he is controlling the process? He wants to die. I don't want him to die. I don't want him not to die. I want him to have control. And so the machine gave control to him. The machine with its laptop screen said, do you want to die?
Do you really want to die? Do you really, really request - three questions which just restated the same thing. He pressed the button three times and then when he pressed it that last time the machine delivered the drugs, I was on the other side of the room watching. But because the machine was
there, I wasn't there. His wife could move into that personal space and hold him and he died in her arms. I'd spent days worrying about everything. In a sense, once the law was passed, the politicians all went back to sleep. Now it became my problem and indeed it wasn't my problem because it wasn't
a very, it wasn't a very, easy to use piece of legislation. The first person, in fact, who came to Darwin to use the law, a taxi driver from Broken Hill. I couldn't get another doctor in the territory to come along and sign his papers and I needed three other doctors to sign his papers. And that
poor taxi driver eventually drove all the way back to Broken Hill in his cab and died there in all the ways he didn't want to. I mean, that was a failure. When it finally didn't work, what did I feel? Well, I knew that against immense opposition, that this was a world first and I was glad to be part
Anthony Levin
Despite the initial milestone, many argue that what happened next is a regrettable part of Australian history. The medical, religious and conservative pushback didn't end with the passage of trailblazing legislation. In fact, it went global. Within eight months, the Howard government stepped in,
using its supreme constitutional power to overturn the law. Three decades later, the NT Parliament is finally reviving the issue. But for now it remains the only jurisdiction in Australia which does not allow voluntary assisted dying.
Nadine J. Cohen
So you've been called many things in your time as an end of life advocate, including Dr. Death, which isn't very inventive, and my favourite, the Willy Wonka of death. What do people misunderstand about your beliefs?
Dr. Philip Nitschke
I think that in any important social change there's going to be a bit of name calling. So I guess I wasn't too surprised that I found myself added to the Wikipedia list of Dr. Deaths And, people said, gee, you must be pretty upset about that. So I went and had a look and sure enough, along with
Josef Mengele and a few other favourites, I did indeed find myself listed there. And it's been there ever since.
Anthony Levin
A quick search on Wikipedia reveals the infamous list of Dr. Deaths. It includes two Nazi war criminals, six serial killer doctors, seven turtledoves, and a partridge in a pear tree. It also includes Dr. Jack Kevorkian, an American right to die advocate, who, like Dr. Nitschke, was often heavily
criticised by the medical and mental health professions. Among the critics of the work that you were doing, many of them were mental health advocates, or at least have been over the years. But you yourself are, no stranger to mental health issues and you've spoken publicly about your struggles with
depression, including extreme hypochondria. You've written about this in your autobiography, "Damned I do" that you entered medicine partly in the hope of, quote, educating yourself out of this debilitating condition, and you discovered that the work of helping people to die with dignity could be
therapeutic for you. How do you separate your passion for the cause from that very personal and arguably therapeutic aspect of doing the work?
Dr. Philip Nitschke
Well, I suppose it's true. I remember having written that when I was reflecting on the whole background there. I mean, I'm not too sure how significant it is. I enjoy doing something which I see as important and I see it as important not because it makes me feel better. I see it as important because
I think it's a necessary social change for the rest of the world and it will improve society if it's brought in. The fact that I get this spin off benefit of making me feel better, I suppose is, slightly interesting. Doing medicine to solve hypochondria is one of the more stupidest ideas I've ever
had. I mean, I learn about unimaginably bad diseases that I wish I never knew about and still wish I didn't know about from doing the course. So in terms of trying to out, educate yourself to remove hypochondria, that's stupid. I would strongly advise a person not to follow in those footsteps. No,
it's really being involved in what I see as a necessary social change that's therapeutic.
Nadine J. Cohen
Switching gear a bit. Can you tell us the difference between voluntary and non voluntary euthanasia?
Dr. Philip Nitschke
Yeah, I think I can. There's lots of different variations and if you just come along and force someone to die, obviously you would see that as murder. And if you come along and just give someone a lethal injection against their will, as often has happened in past pieces of history, that would be
seen and is often called euthanasia, a compulsory forcing of someone to die. And that would be often described as non voluntary euthanasia. Now if a person says, please kill me and you give them a lethal injection, it becomes voluntary euthanasia. Or if, for example, you just give them a glass of,
lethal drugs to drink, then you can define it as an assisted suicide. So I suppose there's a spectrum there. And at some stage, you're giving control of that process to the person who's dying. And at that point it becomes something which I would strongly support. In other words, if an adult of sound
mind says they wish to die, I would strongly support that. Now, in those early days of that legislation and the legislation you now have in all places in Australia, except, interestingly, the Northern Territory, that's the situation of law. You've got to be sick. You've got to be sick enough for
someone else to agree that you're sick enough to be eligible. And you've got to be a person of sound mind. And then a doctor can come along and give you something to drink or give you a lethal injection if you can't carry that out. Now, of course, I see that as a fundamental right. My experience
over the last 20 or so years has meant that I think this should go much further than that. But, nevertheless, I certainly support that idea of what we would describe as voluntary euthanasia.
Anthony Levin
I want to just challenge this idea that the right to die is, in fact, a right. I mean, it's certainly not a right listed in the Universal Declaration of Human Rights. And there are some who say that the right to die is ethics reduced to a bumper sticker. How do you respond to that?
Dr. Philip Nitschke
Well, it's a cute line, I suppose, reduced to a bumper sticker. But, I mean, it's a little more complicated than that. And I suppose people who do the reading of the people's opinions going back from philosophers through the ages about suicide. It's got a long, long history of discussion and debate.
And views do vary on this. I don't have much trouble with the concept that the precious gift of life needs to be one that you can give away. I can also come up with a few one liners too. I mean, a gift you can't give away is not a gift at all. A gift you can't give away is an onerous burden. Now, if
someone tells me you've got a precious gift for life, I would agree with them. But if they say you've got a precious gift of life, but you're stuck with it no matter what, and you can't make a decision whether you have it or not, I would say, come on, what sort of a gift is it? Thanks for nothing.
In other words, you've got to have control over that. Now when I first got involved in this issue back in 1996, that was not the substance of the law and it's not the substance or part of the laws anywhere in the world. Now you've got to be sick. They're medicalised laws. They see it as a privilege
for the very sick which is assessed by some adjudicating authority and traditionally the medical profession. Now I think that's a mistake, but that is nevertheless a commonly accepted view. In other words, they're saying it's not a right at all, it's something of a privilege which will be granted to
you provided you satisfy the necessary prerequisites. And that's where I fall out strongly, I suppose, with my so called new profession, where I don't agree with it. And that's why the debate is really quite interesting. It's happening here at the cutting edge of the debate is on this issue and it's
taking place in Europe, it's not taking place in Australia. In fact, Australia, apart from being that early world leader, dropped into the background after that in that 20 year hiatus and is now doing catch up. I mean the cutting edge of the debate, is it a right or isn't it a right? Is it a
privilege that other people will adjudicate on or is it something more fundamental than that?
Anthony Levin
And is it reasonable to say there's also another category that we could speak of which is where a person is no longer of sound mind but has expressed their wish to die in certain circumstances through some sort of advanced care plan? That if they lose their capacity they instruct their next of kin
or loved ones, to take certain steps. That's also morally complicated, isn't it?
Dr. Philip Nitschke
It's a very difficult one that one. I mean that's an issue which is causing concern and debate all around the world. Certainly here in the Netherlands they've attempted to solve it. This comes up so much in the issues where people are slipping into dementia, such as the dementia caused by
Alzheimer's disease or some other cause where they know they're going to lose mental capacity, which is a prerequisite for the use of laws anywhere that have been brought in around the world. You got to know what you're doing. Now if you're about to lose the ability to know what you're doing, in
other words, slipping into a demented state, how do you solve that? People are fearful and like oh my God, I'm going to move into a situation where I can't give consent, so I won't get help to die. So I better, die early while I still can give consent. People say that's not very good. So how can we
solve the problem of dementia? And what the Netherlands and Belgium have tried to do is introduce things called advanced directives, where you can sign a piece of paper saying that if I slip into dementia, kill me. And that's in operation here in the Netherlands, and it's being debated in other
places like Australia and other countries around the world. Is this a solution? It's not very satisfactory. I know a lot of Dutch doctors, they don't like it very much. And I can see why. I mean, you going around to see some person who's lying there, not knowing which day it is or which way is up
and which way is down, holding a piece of paper signed 10 years ago, saying, if I'm like this, kill me. As a doctor, I don't want to be part of that. I want to know that the person wants to die. And if they've lost the ability to say that, and all as we've got is a piece of paper, I would, as a lot
of Dutch doctors do, feel very uninterested in involvement.
Anthony Levin
We know that capacity can fluctuate, including during diseases like dementia and Alzheimer's. We know from just listening to carers that when they visit their loved ones, they can have good days and bad. And there's some research that suggests that things like music can even activate parts of the
mind and draw a person out of those states of what appear to be lack of capacity. So it is very complicated to make a decision that a person's quality of life is such that the advance care directive should become active. And I can understand why you say that doctors are grappling with this and not
Dr. Philip Nitschke
Yeah, no, I don't see any easy answer to it. I mean, I know - accept the fact that capacity can fluctuate. Now, generally speaking, you've got to have capacity when someone comes along and helps you die. Now, I think that's a very, essential part of legislation all around the world, including places
like Switzerland, that don't require a person to be sick, but you've got to have mental capacity. Now, if you've got a fluctuating situation where you've got mental capacity one day but don't have it tomorrow, well, some people might argue, and I think that's the line you're putting, that if you've
got capacity today, how do you know that tomorrow you won't have. So why don't you just hang around and see what happens? But I mean, surely when you've got capacity, you should be able to say, yes, now's the time to die. The problem is saying, look, if I lose capacity, then kill me. Now that is a
real problem. I don't see any answer other than a technological one that's going to be easily able to address that.
Nadine J. Cohen
Philip, what is a rational suicide?
Dr. Philip Nitschke
Well, rational suicide is where a person makes a conscious decision, an informed and conscious decision to die. For many years now, I've moved from the so called medical model that you have to be sick and someone else has to judge how sick you are to allow you to take this step, to one where I'm
saying that if you're a rational adult, you should have the ability to say this precious gift of life, I want to now divest. In other words, I want to make a decision to die. It's a rational decision that now's the time to end my life. And I would strongly support that view. That's not a view that's
embraced in legislation anywhere other than in Switzerland. But the idea that an informed adult can make this choice and have it acted upon by the provision of the means for a peaceful and reliable death, is something that I, would strongly agree as a fundamental right to a rational adult. Now, I
didn't always think that, and certainly that's not part of the legislative model I worked in in Darwin or the legislative model anywhere else around the world, including here in the Netherlands. But it is part of the Swiss law.
Nadine J. Cohen
And with a rational mind is that complicated by people say, having pre existing mental health conditions. You know, I suffer from major depressive disorder. Am I ever considered to be of rational mind to make that decision?
Dr. Philip Nitschke
Well, this argument has gone on for a long, long time. The idea that anyone who wants to die can't be rational, that is sort of, a belief that's still held by many people within the medical profession. If you're out there seeking assistance to die for whatever reason, maybe even terminal illness,
you can't be of sound mind. In other words, you must have some possibly undiagnosed medical malady which needs to be sorted before we do anything else. In other words, if you're out there asking for help to die, you're sick mentally. Now, that view has largely dissipated over the years. Even in the
medical profession, they've kind of agreed to the fact that perhaps if you're really, really, really sick in fact just about dead, then maybe you can have a sensible and rational decision that you want help to take that step. I'm saying it should go much further than that. Yes, I agree. You should
be able to say that this precious gift of life, for whatever reason I make that decision, you can divest yourself of and have the means to do it. And we're coming across so called people with social, very good social reasons for wanting to die. They're not medical reasons, they're social reasons.
Now should they be having the door slammed in their face or should their views be listened to? The common one is the couple who want to die together. And in Australia, for example, if a couple want to die together, one sick, perhaps terminal fits, satisfies, easily, Victorian law so that the person,
the doctor in Victoria can give them help to die, but their partner, or perhaps of 50 years, who wants to die at the same time, cannot have that, option provided for them. In fact they go along and say, I want to die at the same time as my very sick husband or wife. And they will be told, well you
can't, you're not sick, come back when you are sick. And I say, well that's not any good, I want to die at the same time. So that's an example of a social reason which I would strongly support and it's not acknowledged or in any way, solvable under medicalised laws of rational mind.
Nadine J. Cohen
Does that mean that, you know, someone can't be medicated for depressive or psychotic or anxiety issues?
Dr. Philip Nitschke
Well, the question of mental capacity is one that sort of, causes a lot of difficulty within the medical profession. You can certainly have mental capacity and have, mental illness. The two can coexist. You can have very serious mental illness and still have mental capacity, or you can have no
mental illness and lose mental capacity. So trying to disentangle mental capacity from psychiatric illness is a serious issue, one that we're putting a lot of effort into with our new artificial intelligence assessment of mental capacity. We want to bypass some of the impediments which we're
currently experiencing on this issue.
Anthony Levin
Just to go back for one moment, how often do people ask you to die with their partner if they're elderly?
Dr. Philip Nitschke
Oh, it's quite increasingly common. We would get contact from people once, certainly once a month, probably even more frequently than that. Here in the Netherlands they tend to do it by saying to the partner, oh, you must have a few problems. Usually they're the same age, you're both in your 80s,
you must have a lot of like micro problems and the person plays the game and the laws are bent. As I said, a lot of people go to Switzerland as couples to die where they don't have to go through that charade.
Anthony Levin
We tried to find out just how common it is for couples to ask to die together. To be honest, the research is scant. In the Netherlands they call it duo euthanasia. And one study published in January 2025 suggests that three quarters of Dutch individuals with a partner are open to the idea of dying
Nadine J. Cohen
You mentioned Australia's fallen back. You know, having once been a pioneer in this space; where is Australia at? I know some states have right to die as legislation now and where are we at in terms of the way we're going?
Dr. Philip Nitschke
Well, Australia has sort of caught up again. They've all, every state except the Northern Territory has introduced legislation which allows a person who's sick, sometimes very sick, sometimes so sick they're just about dead. In other words, these are all the so called safeguards and prerequisites to
give you eligibility and access to legislative change which gives you this option. And Australia's got some very conservative, but it does have at last finally brought in legislation, somewhat similar to what you had 25 years ago in Darwin, which allows a very, very sick person to go off. And I call
them "beg and grovel" laws. Beg and grovel to a doctor and say please help me. And then if you're lucky enough to find a doctor who says yes, I will help you get your way and get that assistance now. So Australia has sort of caught up. Victoria was first and then the other states more or less
followed. But every state came along and said, oh, we've got 60 safeguards, oh no, we got 70, we're safer than you, we're going to be the safest. And now even the Northern Territory is talking about having the safest, which as I said means the most restrictive and the most unworkable, what I would
describe beg and grovel law.
Anthony Levin
Intense debates about the safety of voluntary assisted dying laws are also playing out in other parts of the world. For example, in Great Britain, the House of Commons voted to legalise assisted dying in June 2025, paving the way for historic change if it also passes in the House of Lords. In
Philip's view, such debates aren't about the safety of the person seeking help, they're about everyone else.
Nadine J. Cohen
I attended two funerals last year for two men who had participated in voluntary assisted dying. And it was such a incredible moment for these families and for these people. And the funerals were slightly different, had a slightly different air to them. And it was, it was just - I don't wanna say it
was wonderful to experience that because that's, that's the wrong words. But, you know, I was really glad because having lost family to terminal illness in the past and not having that option, I was so glad for my friends who were the loved ones who got to take some ownership with their loved one in
Anthony Levin
And, I think that idea of ownership and agency seems to be at the heart of this. I mean, we have both lost loved ones to terminal illness and watched them die slowly in palliative care. And I've spoken on this show in the first season about the moment when my own mother asked me if I could help her
die by finding some illicit source to do so, and how difficult that was for me. And what a quandary it was. So we've both got some lived experience of these matters.
Dr. Philip Nitschke
Yes. I don't want to give the idea, in my criticism of the legislation that I'm opposed to such laws. I mean, they're a welcome relief compared to the way it was prior to the situation where no law was in place and any assistance was considered a serious crime. So they're to be welcomed, these laws,
the fact that I'm somewhat disparaging, referring to them as beg and grovel laws, et cetera, et cetera, there are still a whole lot better than nothing, and they should be applauded. And people who work so hard to bring such laws in are to be congratulated. And many people, and I can understand why,
see them as a blessed relief compared to the options, alternatives that are out there. But as you said, giving agency is the point. Yes, but agency to who? And, the problem there is - The fundamental problem is that the decision in Australia and the legislative models you have there is not the
patient or the person wanting to die. The decision is being made by the doctors. In other words, the control. The agency is not yours. Now, I'm objecting to that. I'm saying the agency must be with the rational individual. Now, that's not the case anywhere. And that needs to be, I would argue,
Anthony Levin
And so one of the ways you're trying to address this is through technology, isn't it? And you've designed various equipment over the years, which is trying to take some of the medical decision making and the ethical quandaries out of the equation. Can you tell us about that?
Dr. Philip Nitschke
I mean, the very first machine was that Deliverance Machine which I built back in Darwin back in 1996, and that was to take some of the responsibility away from me. Now, ah, since that time, there's been other inventions and moves towards better technology. We're working on artificial intelligence
for mental capacity, which is going well. And we're getting somewhere with a project where it would be an implantable switch, which you set for a year's time. In a year's time, it starts ticking or whatever, and if you reset it, that's fine, it can wait for another year. If you don't reset it, it'll
kill you. In other words, instead of outsourcing your death to some medical professional and putting it all on them, you take responsibility. And the Sarco device has been used in Switzerland, which allows a person to simply climb in and press a button and have a peaceful, reliable death with a
minimal amount of extra intervention.
Anthony Levin
This device has been called the Tesla of Euthanasia. The writers and marketers are forever coming up with snappy little lines to denigrate the work that you've been doing. But can you tell us how this device has gotten you into some legal trouble with prosecutors in Switzerland and maybe elaborate
Dr. Philip Nitschke
Yes, I can do that. I mean, well, it used to be considered to be something of a compliment to be considered the Tesla of euthanasia, but it's slipped a bit in its appeal lately. But look, the idea was I got asked whether or not I could, build something which would allow a very disabled person to
die, a person in London. His lawyers in London made contact 10 years ago, and he said he's got a very serious illness. He's got, Locked-in Syndrome, so he couldn't really move. I said, can we make something that's simple so he can suicide? Because suicide's not a crime. And in most places, suicide
has not been a crime for many years. So can you help him suicide? And I said, well, we can't have some doctor trying to get a needle into a vein, and we can't get him some illegal and difficult to obtain lethal drugs. But if he's alive, he's breathing, so why don't we use gas? And so the idea of
using an inert gas to allow him to die seemed to make sense. And so I sketched up a bit of a capsule where he could, if he could get himself into. The capsule could be flooded with some form of gas which would allow him to take, a deep breath and rapidly lose consciousness and die. And, the lawyers
were interested in that and they took that further. Tony Nicklinson was the person. He died, after challenging British law in the High Court in London.
Nadine J. Cohen
Tony Nicklinson was a British man who suffered a stroke in 2005 which left him paralysed from the neck down. With his eyes as his only way of communicating he described his life as a "living nightmare". And in 2012 he went to the High Court to affirm his right to ask for help to die. Sadly, it
wasn't to be. The court rejected his application after considering the complex interpolation of European human rights law and a UK law which criminalised assisted suicide. Two weeks later, having refused food and treatment, Mr. Nicklinson died from pneumonia.
Dr. Philip Nitschke
But the idea persisted and then Dutch designers worked on it and came up with the nice looking Tesla of the assisted dying movement, which was a futuristic capsule which looked like it was going somewhere. Like a vehicle which you could take to some nice place where you wanted to die. You could
climb in and wave goodbye to all your friends and loved ones and make the day a sense of occasion and press a button and die, very rapidly, by the sudden dropping in oxygen level in the capsule. And that was what we designed and built.
Anthony Levin
The fact that it does look like this space age capsule is one of the reasons why people have criticised you and said that you are glamorising death or glamorising suicide. How do you respond to those kinds of criticisms?
Dr. Philip Nitschke
Well, I suppose the alternative of that is we should make it ugly and offensive and obscene, the opposite of being glamorising. And I mean, I think, as I said, it's the most important day of your life, some would say an important, the most important, the day you die. We're all going to go through
this day. Why not turn it into a sense of occasion, a sense of celebration, a sense of reflection. And because of that I'm not suggesting it should be an ugly event. Now I don't see why it shouldn't be beautiful. I'm very pleased with the work done by the Dutch designers who made this eloquent
looking capsule that could be taken to a nice place where you wish to die and you've got control because you then decide when and where you die, put it where you like, select the time you wish, and because it doesn't require any access to very difficult to obtain lethal drugs, doesn't require the
assistance of the medical profession, it's effectively a way of making a very peaceful, reliable death by suicide available to you at the press of a button.
Nadine J. Cohen
The capsule, or "Death Cap" as Lev calls it, was set up in a forest in a town called Schaffhausen. There to oversee the process was Dr. Florian Willett, founder of Assisted Dying Organisation and most excellent pun, The Last Resort. And waiting to get on board was the world's first Sarconaut. A 64
year old American woman with a rare medical condition. Philip was confident that the use of the device was legal. But shortly after the woman died he says the wheels fell off.
Dr. Philip Nitschke
The Swiss reacted very badly. I call it an overreaction. We didn't expect it. We had a lot of legal advice. Swiss lawyers had told us what would happen. You will be questioned, you will be allowed to go home and it will just fit neatly into Swiss law. But that wasn't at all what happened. Our Swiss
lawyer said make sure that the person who is with the woman who wants to die, she had mental capacity tested by a psychiatrist. But make sure there's only one person or very few people and that they're Swiss people with her when she dies. So it'd be a good idea if you're not there. So I installed
the device in a forest just outside of Zurich in a very nice rural location. I went to Germany on my way to a conference where I was speaking at in Budapest. And she climbed into the capsule and with our Swiss director with her. When she was inside the capsule she waved goodbye and pressed the
button. I watched her die. It was a video, it's a video link from Germany. The person, our Swiss director Florian rang our lawyers and said the person has died. The lawyer said we will be there, we will bring the police. And that's where things started to change. Along came not just the police, but
20 carloads of police turned up into the forest. And we knew this was not going to be treated as your average death and indeed it hasn't been. They arrested our lawyers, they arrested a photographer from the Dutch media who was there not covering the death but just looking at the background to the
issue and they arrested our Swiss director. They've kept him in jail for 10 weeks in so called pre trial detention. Finally the lawyers got out after 48 hours. The media got out after 48 hours. But it was very clear that this was not going to be your average Swiss assisted suicide. And we still are
going through all of the legal follow up from that.
Anthony Levin
Under the Swiss penal code, an assisted suicide is only legal if it is done for an altruistic purpose. According to Philip, Swiss prosecutors will likely argue that that he and his colleagues were using the Sarco for self promotion, making it criminal. But at this stage, although the prosecution
remains on foot, its chances of success are, uncertain. That's because in May 2025, in an incredible plot twist, the Swiss man at the centre of the arrests, Dr. Florian Willard, died by assisted suicide just five months after his release from detention.
Nadine J. Cohen
How do you test a device like the Sarco to make sure it's humane?
Dr. Philip Nitschke
The testing, it was instrumental testing. We were making sure that when you press the button, the levels of oxygen in the capsule, did what they were supposed to do. It's a precipitous drop. I designed the generator which rapidly allows the oxygen level in the capsule to drop. We didn't test using
animals or any of that nature, and people said, how did you know it was going to work? And I suppose really what we're saying is we know what happens to people when they're suddenly finding themselves in an environment where the oxygen level has dropped rapidly to less than one percent. You know,
you lose consciousness within one or two breaths and die very peacefully five minutes later. So we knew about that. We didn't actually test that. And I suppose in a sense that first use of the device was, was in fact, if you like, the test where an actual person made use of the device and she died
in the way that was expected.
Nadine J. Cohen
Where are you at with making peace with death?
Dr. Philip Nitschke
Well, I don't know, given my background in hypochondria. Well, I mean, I don't think I'm looking forward to it, put it that way. One thing that is causing trouble for people who want to have absolute control and we see it everywhere. We've got members all around the world of our organisation, a lot
of them in Australia and they say, look, thanks for the laws that have come in, but we want control. I want something in the cupboard that I can go to and take and die and I control it. Now that's a very, very, very common request by our 80 year old members. They want something. Now it's damn hard
to get a drug that will do that properly. There's been drugs that will do it, but they're very hard to get. So I'm in the fortunate position of actually having access to those drugs. So I can go to the cupboard after this interview and quickly have a drink and be dead within five minutes.
Anthony Levin
For the record, Philip didn't go to the cupboard and have a quick drink five minutes after our interview.
Dr. Philip Nitschke
So, have I thought about my death? Yes. I could do that, but I kind of like the elegance and simplicity of the Sarco. So we're busily printing another one, giving that our first one is heavily, heavily entrapped by the Swiss authorities, even though it's been requested by two other museums in the
world who want this device. They can't have it right now because the Swiss authorities are keeping it there pending the possible trial. So I will have another one up here. So I suppose I can tow it down to the sand dunes overlooking the North Sea out of Amsterdam and climb in and die at the time of
Anthony Levin
Philip, I have to ask, how does your partner feel about having a death cocktail in the pantry cupboard?
Dr. Philip Nitschke
Well, Fiona Stewart, is quite comfortable about the knowledge that the death cocktail is in the cupboard. She also knows where it is. So I guess she also has the benefit of, knowing that she too feels like, the time has come, which now means that it is the right time to leave this planet, that she
too can go to the cupboard and take that drink. So it actually provides benefits for both of us. People say, what if you have a bad day, you might go to the cupboard. Look, I've had a lot of bad days, but I haven't been, at this stage, of the opinion the day is so bad that I want to go to the
cupboard. The fact that I've got something in the cupboard makes me feel like I'm in control. And I would argue that people who do have something in the cupboard live longer because they're not so troubled by the feeling that there could be some unprecedented precipitous bad event which might prompt
them to do something like go to the cupboard. In fact, it actually probably, surprisingly and paradoxically, having a lethal drug like that in the cupboard probably extends life.
Anthony Levin
I mean, you may be more strong willed than some people. And there may be some people who, if they had a very bad day or a very bad week, they might be vulnerable to making a bad decision. Isn't there some force to the argument that having such drugs or equipment or assistive technology available
raises the prospect for misuse or abuse or poor decision making?
Dr. Philip Nitschke
Obviously it does, raise the possible risk that someone might misuse these drugs or they might get discovered by someone else and accidentally lead to death or all sorts of things. So there are possible risks there. And I've got plenty of evidence, anecdotal, that people who have access to drugs in
the cupboard live longer. I don't mean just lying on the kitchen table, I mean locked away in the cupboard. Actually live longer. So you've got to then try and balance between that vulnerable group who might have bad days and misuse this option and die earlier than perhaps they would if they didn't
have this choice against that large group of people who are living longer because they do have this choice. Is it better to prolong the life of a large number of elderly people, putting them back in control against the premature, and earlier deaths of people who misused this option? It's a very hard
way to make that decision. But that concept which we tend to use in many countries, that the best thing to do is to make sure that no one has access is a way of trying to reduce suicide rates, which is, of course, a governmental policy here. How can we reduce suicide rates, make sure that no one
ever has access to these substances? And it seems to be a quaint notion. The idea seems to be that if you don't, if you can't die, you won't die. If you don't know how to die or you haven't got the access of the means to do this, you'll just sit there and live forever, looking at the wall and
smiling. And, that's what governments around the world do. They restrict access to the means as a way of trying to control and reduce suicide rates. But what they do is lead to a large number of unhappy other people that don't have the control that they seek.
Anthony Levin
And what would be your deathbed confession?
Dr. Philip Nitschke
I've got some deathbed regrets. I'm not sure about confessions. Things that I've done wrong, things that I should never have done. I've made a lot of mistakes, and a lot of them I regret. And I wish I hadn't made. And I guess I'm very fortunate to have got through. I regret deeply the fact that I
didn't help my mother when she asked me for help to die. And you mentioned that earlier in the discussion. It puts a person into an awful position, she said, as she sat for many years in a very nice nursing home. But she said, I'm sick of this. All my friends are dead. Can't you give me something
that can help me die? And then she said, oh, I know you can't, she said, because you're a person that would be immediately watched because of your involvement in this issue. But I wish you could help me. So - and I kind of agreed with her that it was rather difficult given that situation, especially
as evidenced by the fact that minutes after that conversation, when members of the nursing staff who were attending asked her how she was going, she said, awful, I wish I was dead. And the next thing we know she had a psychiatric review brought in from outside because they felt that she was being
perhaps affected by and influenced by my views. I mean this whole issue is such, of such sensitivity amongst the institutions looking after elderly people. But, the point still remains. She should have had this option. If she had it, she would have taken it.
Anthony Levin
There's no small irony in the fact that Dr. Death himself was unable to help his mother at her request.
Dr. Philip Nitschke
No. It's very embarassing.
Anthony Levin
You once said many years ago that you would be happy to take your bottle from the cupboard and go and die in the Gibson Desert and leave your body for the crows. Now that you're no longer near the Gibson Desert. Is it the canal or something else?
Dr. Philip Nitschke
Yeah, it is a bit of a pity. I mean my - After many years working in Central Australia at Parks and Wildlife as a wildlife ranger, the deserts do have this, do have this attraction, the seduction and the appeal. I'm trying to get a Sarco into the desert is going to be difficult. But I guess if I've
got a bit, if I've got a bit of warning, if I've got a bit of warning, I guess I can get back to Australia and head out into the Gibson.
Nadine J. Cohen
I'm picturing the Priscilla Queen of the Desert's accoutrement on the Sarco driving through the desert.
Anthony Levin
Well, thank you so much, Philip, it's been a pleasure talking to you and we've really appreciated how willing you were to go, to go there and I've certainly learned a lot listening to you.
Nadine J. Cohen
Thank you so, so much.
Dr. Philip Nitschke
Thank you.
Nadine J. Cohen
So that was Dr. Death Thoughts, feelings?
Anthony Levin
Yeah, that was really interesting, but also raised some really tough questions, none of which I have the answer to. But the thing I'm thinking about is, is technology and its potential ability to eliminate some of the moral and ethical quandaries of VAD [Voluntary Assisted Dying] And in particular,
I'm thinking about Philip's comments about AI. It is, as we know, revolutionising every aspect of society and death is not immune. It's coming for death as well. The case of Tony Nicklinson in the UK kind of illustrates the point. It's at that bleeding edge of this issue because his family described
his condition as being like buried alive in his own body, which sounds so horrific. So I think that there are always going to be scenarios which push the boundaries of these laws and the drafters and the Parliament, they need to put themselves in the shoes of people suffering complex conditions and
their families so that the laws can meet the needs of people who want to die with dignity.
Nadine J. Cohen
Yeah, absolutely. So thanks again to Dr. Philip Nitschke for a challenging discussion. Our next episode is about two of my favourite things, zombies and vampires. We'll be talking to undead expert Dr. Emily Zarka about monsters in history, "Buffy the Vampire Slayer" and prepping for the zombie
Dr. Emily Zarka
They do think that monster history is human history, and part of that is, we're going to keep making monsters, and we always have, because we always feel like we are living in horrible situations in the worst time.
Nadine J. Cohen
If this episode has raised issues for you and you'd like to seek mental health support, you can contact Beyond Blue on 1300 22 46 36 or visit beyondblue.org au Also, Embrace Multicultural Mental Health supports people from culturally and linguistically diverse backgrounds. Visit
embracementalhealth.org.au. For 24/7 7 crisis support, call Lifeline on 13 11 14 or in an emergency, please call 000.
Anthony Levin
"Grave Matters" is an SBS podcast written and hosted by me, Anthony Levin, Nadine J. Cohen and produced by Jeremy Wilmot. The SBS team is Joel Supple, Max Gosford, Bernadette Phương Nam Nguyễn, and Philip Soliman. If you'd like to get in touch, email audio@sbs.com.au Follow and review us wherever
